ANA SOFIA CUEVA MOSCOSO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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- Altered Intracortical Inhibition in Chronic Traumatic Diffuse Axonal Injury(2018) HAYASHI, Cintya Yukie; NEVILLE, Iuri Santana; RODRIGUES, Priscila Aparecida; GALHARDONI, Ricardo; BRUNONI, Andre Russowsky; ZANINOTTO, Ana Luiza; GUIRADO, Vinicius Monteiro de Paula; CUEVA, Ana Sofia; ANDRADE, Daniel Ciampi de; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaBackground: Overactivation of NMDA-mediated excitatory processes and excess of GABA-mediated inhibition are attributed to the acute and subacute phases, respectively, after a traumatic brain injury (TBI). However, there are few studies regarding the circuitry during the chronic phase of brain injury. Objective: To evaluate the cortical excitability (CE) during the chronic phase of TBI in victims diagnosed with diffuse axonal injury (DAI). Methods: The 22 adult subjects were evaluated after a minimum of 1 year from the onset of moderate or severe TBI. Each of the subjects first had a comprehensive neuropsychological assessment to evaluate executive functions-attention, memory, verbal fluency, and information processing speed. Then, CE assessment was performed with a circular coil applying single-pulse and paired-pulse transcranial magnetic stimulation over the cortical representation of the abductor pollicis brevis muscle on M1 of both hemispheres. The CE parameters measured were resting motor threshold (RMT), motor-evoked potentials (MEPs), short-interval intracortical inhibition (SIICI), and intracortical facilitation (ICF). All data were compared with that of a control group that consisted of the healthy age-matched individuals. Results: No significant differences between the left and right hemispheres were detected in the DAI subjects. Therefore, parameters were analyzed as pooled data. Values of RMT, MEPs, and ICF from DAI patients were within normal limits. However, SIICI values were higher in the DAI group-DAI SIICI = 1.28 (1.01; 1.87) versus the control value = 0.56 (0.33; 0.69)-suggesting that they had a disarranged inhibitory system (p < 0.001). By contrast, the neuropsychological findings had weak correlation with the CE data. Conclusion: As inhibition processes involve GABA-mediated circuitry, it is likely that the DAI pathophysiology itself (disruption of axons) may deplete GABA and contribute to ongoing disinhibition of these neural circuits of the cerebrum during the chronic phase of DAI.
bookPart Bases do Tratamento Farmacológico da Dor(2015) GALHARDONI, Ricardo; TEIXEIRA, Manoel Jacobsen; SIQUEIRA, Silva R. T. D.; SIQUEIRA, José Tadeu T. de; CUEVA, Ana Sofia; ANDRADE, Daniel Ciampi debookPart Síndromes Dolorosas(2015) CUEVA, Ana Sofia; RAICHER, Irina; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi debookPart Situações Especiais em Clínica de Dor(2015) CECíLIO, Sofia; ANDRADE, Daniel Ciampi de; CUEVA, Ana Sofia; RAICHER, Irina; TEIXEIRA, Manoel Jacobsen- Normative data of cortical excitability measurements obtained by transcranial magnetic stimulation in healthy subjects(2016) CUEVA, Ana Sofia; GALHARDONI, Ricardo; CURY, Rubens Gisbert; PARRAVANO, Daniella Cardoso; CORREA, Guilherme; ARAUJO, Haniel; CECILIO, Sofia Barros; RAICHER, Irina; TOLEDO, Diego; SILVA, Valquiria; MARCOLIN, Marco Antonio; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi deObjectives. - To obtain normative data for CE measurements by transcranial magnetic stimulation, to assess inter- /intra-investigator variability and the influence of sex, age and oral contraception use. Methods. - A sample of 216 healthy volunteers matched according to age and gender was evaluated. Bilateral rest motor thresholds, motor evoked potentials (MEP), intracortical inhibition and facilitation were measured in the first dorsal interosseous muscle area representation of the primary motor cortex with a circular transcranial magnetic stimulation coil delivering biphasic pulses. Normative data were obtained for 200 participants (in a 1:1 male:female ratio) in a balanced proportion between five age groups (18-30; 31-40; 41-50; 51-60; > 60 years). Inter/intra-investigator variability was assessed in 20 healthy volunteers in two sessions performed within a 30-minute interval. Measurements were also performed in a subgroup of 16 healthy female volunteers, using oral contraception and during the menstrual phase. Results. - Age had a dichotomous effect on CE measurements, providing significantly different normative data for subjects < 50 and > 50 years old, with smaller MEP's and intracortical inhibition in older individuals. There were no differences between genders or between left and right hemispheres. Also, CE parameters did not significantly differ with use of contraceptive treatment compared to the menstrual phase of the cycle. The inter-/intra-investigator reliability assessment showed some variability that may not be clinically significant. Conclusions. - Age had a non-linear effect on CE. There were non-significant differences between genders, hemispheres or with use of oral contraceptives. There was good inter- /intra-investigator correlation for rest motor thresholds and motor evoked potentials while intracortical inhibition and facilitation had low correlations but acceptable reliability. 2016 Elsevier Masson SAS. All rights reserved.